Maplewood News

Kathryn Kindopp, Administrator, Maplewood Nursing Home

Do you know Cheshire County’s best kept secret? Maplewood Nursing Home! Whether for a short placement for rehabilitation between a hospital stay before returning to your home, or for a longer term living environment – Maplewood is “closer than you think”. Maplewood has an excellent reputation for good care. Everyone is welcome, we are like family.

Maplewood is the longest running long-term care facility in Cheshire County. Our current building is nearly 40 years old, and though it’s described as having been built like “Fort Knox”, it is admittedly showing some signs of aging on the interior. As we are funded in part by the tax payers of Cheshire County, and any bonded construction project would have tax implications, we have set out to study this home.

A large group of stakeholders have been assembled and are meeting regularly to discuss any and all options for our future. Residents and families have been contributing thoughts and energy into this project. We hope to have a report from the study committee in 2014 about a recommended future for Maplewood.

Maplewood Nursing Home – Yesterday, Today and Tomorrow

A three-part report on this important Cheshire county Asset.
By Kathryn Kindopp, NHA, PT

In rural Westmoreland, nestled on the banks of the Connecticut River, lies Maplewood Nursing Home, the county-run nursing home. In a situation unique in modern America, every county in New Hampshire has a similar facility.

Probably most Cheshire County residents rarely think about the home, but it bears a long and colorful history, and continues to serve as a valuable resource to this corner of the Granite State. Currently, a committee has been formed to determine the future of the home. Hopefully, this story will give the citizens a perspective on the Home- how it got here, what it contributes to the County, and its possible future options.

The Past…

The very existence of our County Homes can actually be traced back to 1608, when the English Parliament passed the Poor Law. For the first time in history, there was an acknowledgement that government has a responsibility to assist its more vulnerable citizens.

The early Colonists to this area- mostly English – carried that sense of responsibility with them, and nowhere was that more evident than in New Hampshire. The first settlers who trickled into what became Cheshire County after 1733 were mostly farmers and small tradesmen. “Ownership” of the area went back and forth between Massachusetts and New Hampshire (and occasionally Vermont), providing little support for these rugged, independent individuals and their families.

At first, with only scattered settlements, the elderly and infirm remained within the family units, but by the eighteenth century, the various towns would pay an individual or family to take these “paupers” into their own homes- at least those that the towns were unable to drive away. Potential hosts would enter bids to the town, which invariably opted for the low bidder (some things do not change- even NASA follows this policy today). Records from the early 1800’s indicate that the towns paid between $11-16 per year- not exactly a generous sum.

“Reformers” in the early 1800’s advocated that it was more humane (and cheaper) to house the elderly, invalids and ne’er-do-wells in “asylums” rather than in individual homes. The overall success of this concept may be judged by a particularly infamous asylum in London named “Bedlam”- a word that has carried forward in the language to this date.

The first such institution in this area was in Westmoreland in 1832. The former Daggett Farm served as town farm and asylum. Since petty criminals and drunks were a part of the inmate population, farm work was a requirement, and supposedly helped to reform these reprobates.

Until mid- century, each town had a version of this, though eventually criminals were housed separately. By 1866, Cheshire County agreed to take over control of these poor farms, constructing a facility at the present site of Maplewood Nursing Home. The site was purchased for $13,000, and a new alms house was constructed for an additional $2700. Eight years later, an additional $200 was allotted to add a house of correction.

This proved to be a poor decision, as the criminals did not mix well with the mostly elderly population, and the housing was sub-par (not surprising, for $200). As a result, the House of Correction was moved to Keene in 1885, unlike a number of New Hampshire counties, where the prison remains in a separate building on the same site.
In 1896, the County constructed a separate building for the insane, inasmuch as “incurable insane and imbeciles were annoying and difficult to manage.” The building proved inadequate, and early in the 20th century, these individuals were moved to the New Hampshire State Hospital.

Through the early 20th Century, continued with moderate building improvements, but little change in care or approaches, under the direction of a matron who was more a political appointee than an experienced caregiver. Throughout this period, the farm was an essential part of the operation, providing food, and sometimes income for the operation.

In 1916, additional land was purchased and Maplewood became a licensed hospital, catering to chronic care, while continuing to care for infirm elders.

The location on the banks of the Connecticut was scenic, but presented hazards as well. In 1927, a major flood destroyed much of the property, followed by a destructive fire in 1933.
In 1946, the Home began providing shelter for orphaned children, as well, and the prison was authorized to accept federal as well as state and local prisoners.

In 1959, Maplewood was first granted a license as a nursing home, with an initial complement of 29 residents. The passage of the Medicare/Medicaid law in 1965 greatly increased the demand for nursing home services, and increasingly the population became more focused upon aging county residents.

In 1972, a new jail was constructed out in Westmoreland. Two years later, plans for a new nursing home were approved, and the present 150-bed facility opened in 1977.

The next major step was the addition of 20 assisted living apartments in 1999, while the farm was leased to a private firm. In 2010, a new jail was constructed in Keene, leaving the nursing home and farm on the existing location.

Today, Maplewood Nursing Home continues to serve the elder population of Cheshire County….but that is a story for next time.

Task force to study Cheshire County’s nursing home

A task force will work for the next six to eight months to recommend what to do with Cheshire County’s 40-year-old nursing home in Westmoreland.

Last Monday afternoon, a task force consisting of 15 Cheshire County residents — including state representatives and those in the health-care industry — met for the first time to discuss the 148-bed Maplewood Nursing Home. The nursing home has structural problems and faces about a $2.5 million budget deficit.

Most of the home’s debt comes from a decrease in federal funding for Medicaid patients, who make up about 89 percent of the residents at Maplewood.

Many of the residents there need significant help. Ninety percent are unable to bathe themselves, 85 percent cannot dress themselves and 65 percent need help when moving from a bed to a chair.

Cheshire County Commission Chairman John M. Pratt, D-Walpole, said the task force will need to decide what’s best for the nursing home, its residents and Cheshire County citizens. The task force will also consider whether the nursing home should go private, discharging the county from its responsibilities. Maplewood has historically accepted residents who would otherwise be turned down because they can’t afford the stay.

Last Monday afternoon, task force members discussed some ways they could better understand the nursing home’s problem.

Task force Chairman John E. Hoffman Jr. of Sullivan said nursing homes nationwide are trying to provide affordable care to an increasing aging population. He said it’d be worth it to look at how other nursing homes — public and privately owned — handle similar situations.

The committee also talked about visiting the nursing home to look at some of the problems firsthand. Committee members said they would like to talk to those who live there, those who work there and those who have family there. Some committee members have family at the nursing home.

The task force also talked about possibly moving the nursing home to a more central location, such as Keene, because Westmoreland seems to be too far for residents in some Cheshire County towns.

“You don’t get a lot of people from Rindge going to Maplewood,” state Rep. John B. Hunt, R-Rindge, said.

County Administrator John G. Wozmak said if the task force recommends building a new facility, rather than fixing up the current one, it will mean spending much more. Cosmetic improvements and some upgrades would cost $12 million and renovations with minor additions would cost $22 million, according to a consultant’s report issued in January. If a new facility were built in Westmoreland, it’d probably be about $60 million, Wozmak said, and more if the location was Keene — $62 million, according to the report.

Keene Mayor Kendall W. Lane, a committee member, said the financial dynamics of operating the nursing home need to change, such as increasing the amount of revenue the facility brings in. Others agreed with him.

The group will also be seeking public input. Hoffman said this will take some time, and he expects the group to meet for another six to eight months.